Objective: To assess the incidence and risk
factors of minor and major hypoglycaemia in patients with type 2 diabetes.

Research Design and Methods:
This wasa retrospective, cross-sectional
analysis of 2,272 adults with type 2 diabetes, attending a diabetes clinic between
April 2008 to May 2011. Minor hypoglycaemia in the preceding month and major
hypoglycaemia in the preceding 12 months were the primary outcomes. Logistic
regression analysis was used to determine the following risk factors for minor
and major hypoglycaemia: age, sex, diabetes duration , HbA1c, presence of
cardiovascular disease, microalbuminuria, peripheral neuropathy, renal
impairment, central obesity, activity level, smoking status, glycaemic therapy.

Results: The incidence of minor hypoglycaemia was
11.1%, while that of major hypoglycaemia was 0.7%. Among those not on insulin,
the incidence of minor hypoglycaemia increased with
the number of oral hypoglycaemic agents; each additional agent increased the relative
risk of hypoglycaemia by 45%. The strongest independent predictor of minor hypoglycaemia was insulin
use, while for major hypoglycaemia it was disease duration. Other independent
predictors for minor hypoglycaemia were diabetes duration and the presence of
peripheral neuropathy, while those for major hypoglycaemia were insulin use, cardiovascular
disease and female sex.

Conclusions: In this large cohort with type 2
diabetes, insulin treatment and diabetes duration are strong and independent
risk factors for minor and major hypoglycaemia. This study proposes that peripheral
neuropathy may be a predictor of minor hypoglycaemia and demonstrates that cardiovascular
disease is an important and novel predictor of major hypoglycaemia. Study
findings can direct education regarding hypoglycaemia and development of
strategies to reduce hypoglycaemia.